Sunday, January 22, 2017

I am glad that we have a new president. Like most of the country, I was
ripe for a change of direction and a new approach to foreign and domestic
affairs – and we are certainly getting that.
New readers here might erroneously suspect that I voted for Trump. I didn’t. For the first time in my presidential voting
history, I wrote in my choice for our top two office holders.

I have written multiple posts on my unfavorable views of Obamacare
since it was jammed through congress without a single Republican vote. (Do I sound slightly partisan here?) Interested readers are invited to peruse
posts on this blog within the Health Care Reform Quality category, if you dare.

There are two kinds of people who oppose Obamacare

Folks who believe it is wrong on policy grounds

Folks who wield it as a political cudgel to bash Obama.

Some opponents are a hybrid of both of the above.

I was also suspicious that the Affordable Care Act (ACA) was
always an interim step preceding a full nationalization of our health care
system. Obama is on the record favoring
such a policy during his 2008 campaign. If
Obama could have achieved this politically in one step, he would have. The ACA represented the political upper limit that
he could achieve, hoping that this would make a full would bring us within reach of a government takeover. Some conspiratorial skeptics believe that the
ACA was designed deliberately to fail so that private insurance companies would have to
abandon it – as they have. Then,
the beneficient government would have to step in to rescue Americans who needed medical
coverage STAT! While I offer no opinion
on this wild charge, there were many smart people who averred when the ACA was
delivered to us, that the numbers would never add up. And they didn't.

Derailing the Obamacare Runaway Train

It is my belief that government is simply not equipped to assume control of the entire health care system and operate it at the highest level of
quality possible, while controlling costs. Remember how smoothly
the healthcare.gov web site release was?
Do you think this would have happened if Google, or Facebook was
in charge? Which company do you have a
higher opinion of in terms of quality and efficiency, the Bureau of Motor
Vehicles or Amazon? If folks want to
have a government insurance plan like Medicare, I am fine with this. But, give us access also to the free market. I like choice because competition breeds
excellence. When FedEx came onto the scene, it forced the U.S. Postal Sevice to really step up, which they have.

And, we all know that the plan’s proponents were somewhat
less than truthful. Feel free to GOOGLE
Jonathan Gruber to become reacquainted with his 2014 comments which make
reference to stupid American voters and other niceties. How long did it take the Obamians to admit
that the statement, “If you like your doctor, you can keep your doctor”, was
known to be false from the outset?

Let’s face it. The
ACA promised us quality and cost control and in my view it has failed on both
counts. I do congratulate the president
here, as I have previously, for taking on the challenge of health care
reform. Republicans over several
presidential administrations failed to seriously confront this challenge. And the plan does cover more Americans, which
we all agree is a necessary goal. But,
the collateral damage of this achievement warrants a new direction, admitting
that it may not be possible to uproot the entire tree.

The replace part is going to be tougher than the repeal
part. Will the GOP take a lesson from
their adversaries and jam it through without a single Democrat vote?

3 comments:

Anonymous
said...

Agree with most of what you said.However,"Will the GOP take a lesson from their adversaries and jam it through without a single Democrat vote?"I am curious, if right thing is being done, on sound economic and behavioral basis, then why it is needed to seek the agreement and blessing of the other side that did exactly opposite, and with inappropriate force?

Of course, I understand your point. Clearly, both sides are not only considering the merits here. Back when Obamacare was passed, you recall that 100% of the GOP voted against while (I think) all DEMS voted for it. Is it really possible that any issue could divide along party lines only on the merits? I don't think so. I challenge you to come up with any decent idea that would get 100% support from one party and 100% opposition from the other. When this occurs, it means that politics are at play, which I think is inarguable. Look where this got us. The GOP would be better served, in my view, if they could earn some DEM support for the Replace Obamacare phase. However, will any DEM be permitted to cross the line over to them? I wonder. Unfortunately, the politics will 'trump' the policy. Thanks for commenting.

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About Me

I am a full time practicing physician and writer. I write about the joys and challenges of medical practice including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When I'm not writing, I'm performing colonoscopies.